HomeMy WebLinkAbout52372 MID STATE TRUCK EQUIP INDIANA RETAIL TAX EXEMPT PAGE 1
Ir ` 'i CERFICATE NO.003120155 002 01. 2ity "'" `"" FEDERAL EXCISE TAX EXEMPT PURCHASE ORDER NUMBER
52372
35-60000972
ONE CIVIC SQUARE
CARMEL,INDI=NA4SC,?2-2E z.. THIS NUMBER MUST APPEAR ON INVOICES,A/P
VOUCHER,DELIVERY MEMO,PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
1/24/2019 01/28/19 18704 201250 Snow plow repair parts
Mid State Truck Equipment Inc. Parks Maintenance
11.020 Allisonville Rd 1427 E. 116th Street ATTN:Courtney
VENDOR Fishers, IN 46038 To P Carmel, IN 46032
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
5.000 each MSC01870 plow marker Pair $22.8800 $ 114.40
3.000 each MSC04898 Boss plow headlight complete assy. $562.4800 $ 1,687.44
1.000 each Shipping . $30.0000 $30.00
GLAccount#1125401-4232100
Send Invoice To:
$ 1,831.84
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.NUMBER IS MADE A
PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN
SHIPPING INSTRUCTIONS AFFIDAVIT ATTACHED.
• I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION
• SHIP REPAID. SUFFICIENT TO PAY FOR THE ABOVE ORDER.
• C.O.D SHIPMENTS CANNOT BE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. ORDERED BY Neil Whitehead
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 ry \(ail
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE (�\
CLERK-TREASURER
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DOCUMENT CONTROL NO. 52372 VENDOR COPY o